Özcan Mutlu, Volpato Claudia Angela Maziero
University of Zürich, Division of Dental Biomaterials, Center of Dental Medicine, Clinic for Reconstructive Dentistry, Zürich, Switzerland.
Federal University of Santa Catarina, Health Sciences Center, Department of Dentistry, Florianópolis, Brazil.
Jpn Dent Sci Rev. 2020 Nov;56(1):216-223. doi: 10.1016/j.jdsr.2020.08.002. Epub 2020 Sep 17.
Adhesion science is one of the greatest contributions to restorative dentistry. Adhesion not only established the current principles of tissue preservation, but also allowed for the production of more hermetic and long-lasting restorations. Although adhesive strategies are routinely used in most clinical situations, adhesion to root dentin is still a major challenge. The presence of humidity together with less intertubular dentin are factors that limit the adhesive potential of root dentin. This situation is more unfavorable in endodontically treated teeth prepared for prefabricated or custom-made intraradicular posts; these procedures may alter the mechanical properties of teeth by modifying the viable dentin surface for adhesion. Also, contaminants deposited on the dentin surface are difficult to remove through conventional techniques. Moreover, root canal morphology has a very unfavorable C-factor, bringing undesirable effects resulting from polymerization contraction of resin-based materials. However, the differences between coronal and root dentin are not a barrier for dentin adhesion. Standardization of procedures and care during clinical steps are fundamental to the success of adhesion to coronal or intraradicular dentin. Thus, it is essential to know the anatomy of the root structure, the factors that interfere with intraradicular adhesion, as well as the current adhesive materials and techniques.
粘结科学是对牙体修复学的重大贡献之一。粘结不仅确立了当前的组织保存原则,还使得制作出更密封、更持久的修复体成为可能。尽管粘结策略在大多数临床情况下都被常规使用,但与根面牙本质的粘结仍然是一个重大挑战。湿度的存在以及管间牙本质较少是限制根面牙本质粘结潜力的因素。这种情况在为预成或定制的根管内桩进行根管治疗的牙齿中更为不利;这些操作可能会通过改变用于粘结的活髓牙本质表面来改变牙齿的机械性能。此外,沉积在牙本质表面的污染物很难通过传统技术去除。而且,根管形态具有非常不利的C因子,会导致树脂基材料聚合收缩产生不良影响。然而,冠部牙本质和根部牙本质之间的差异并非牙本质粘结的障碍。临床步骤中操作程序的标准化和谨慎是与冠部或根管内牙本质粘结成功的基础。因此,了解牙根结构的解剖学、干扰根管内粘结的因素以及当前的粘结材料和技术至关重要。